The NHS: even more cherished than the monarchy and the army

New polling by British Future shows that while attitudes to the NHS have fluctuated, commitment to its founding principles has remained remarkably consistent.

January often heralds a couple of weeks of absent mindedly getting the year wrong, but it has been easier than usual to remember that it is not 2012 anymore. 2013 feels like an altogether more ordinary year, after the exuberance of the Olympics, as attention returns to the long slog through the economic crunch.

Yet it turns out that the national events of 2012, gently satirised as the year of the "Jubilympics", do not represent the main sources of national pride in Britain.

The NHS beat both the monarchy and the Olympics to take gold in the patriotism stakes, as Ipsos-Mori's polling for British Future's new State of the Nation 2013 report, published today, shows. The army ranked second, when pollsters asked people which institutions made people proudest to be British, with Team GB taking bronze, nudging the royals off the podium altogether.

The NHS was most popular with Britons from all backgrounds, being top for both white and non-white Britons, and across social classes, though the oldest segment of the population put the monarchy first, and the under-24s the army.

Seventy two per cent of people declared the NHS to be "a symbol of what is great about Britain and we must do everything we can to maintain it" while one in five (21 per cent) saw it as "a great project for its time, but we probably can not maintain its current form".

That helps to explain why the 65th birthday of the NHS also provides the anniversary of 2013 which is most cherished by the public, proving more popular (on 54 per cent) than the 60th anniversary of the Coronation (43 per cent) with the discovery of the structure of DNA (29 per cent). Anniversaries of the London Underground  (15 per cent), the Beatles (15 per cent), Jane Austen's Pride and Prejudice (11 per cent) and the Football Association (eight per cent) and Doctor Who (seven per cent) trailed. The 40th anniversary of EEC membership did worst of all, with just three per cent of people choosing that as a source of British pride.

Firstly, the NHS fully merited its place in Danny Boyle's Olympic opening ceremony. While attitudes on the performance of the NHS have fluctuated a great deal - affected by events, funding and political controversies -  commitment to its founding principles has remained remarkably consistent.

Secondly, there is a message for politicians here too. Politicians or wonks who want a radical overhaul of the NHS often express frustration at the level of public sentiment behind it, reflected in Nigel Lawson's famous rueful description of the NHS as "the closest thing the English have to a religion". The debate has echoes of that over the monarchy, with many of the roles reversed, as liberal-left defenders draw on a reservoir of symbolic sentiment, while right-of-centre wonks mutter about the difficulty of breaking through with a "rational debate" given the resonance of that frame.

The poll shows why it made a lot of sense for David Cameron to seek to define himself, in opposition, as a champion of the NHS, though the polarised controversy over the motives and outcomes of the coalition's NHS reforms made that a deeply contested question. The breadth of support for the NHS as a symbol in this poll underlines the lesson that support for change to the NHS depends on securing trust about motivation and intention. Any reform, from whatever poltical perspective, will have a chance of public support if changes are understood to be upholding the core NHS principles. They will be treated with suspicion if thought to be subverting them.  Those who want to change the NHS may need to learn to love it first.

But if the NHS represents a now deeply entrenched fairness ideal - that healthcare should not depend on the ability to pay - I suspect the strength of attachment to the NHS goes well beyond the politics of healthcare, and is much more personal, reflecting its presence on some of the most important days of our lives.

I am a child of the NHS. I feel a particular connection to it because I wouldn't exist without it.  I was born in a hospital, the Doncaster Royal Infirmary, in spring 1974, under the care of the NHS, because my parents, born 4,000 miles apart in Guajarat, India and Cork, Ireland, had both come to this country to work for the NHS. That is also the everyday story of how our most cherished national institution has always depended on immigration, and integration, to be able to offer its public service.

But my main memories of the NHS are that its hospitals are also where my children were born. It is where we have the serenity of knowing that we can go - once or twice on an  adventure to drive out to see the "night doctor" in the middle of the night - to check everything is OK. We cherish the NHS because it turns the idea of "cradle to grave" from a metaphor into a reality.

The only cloud on the horizon was a dip in support among the under-24s, who placed the army ahead of the NHS as a source of pride. That reflects a broader inter-generational erosion of support for ideas of welfare and social solidarity more generally, set out in Ipsos-Mori's work on attitudes shifts across generations.

There will be wide support for celebrating the 65th birthday of the NHS this year - but it may be an open question whether the moment could be used to extend its appeal for several more generations to come.

British Futures's new report, State of the Nation: Where is bittersweet Britain heading?, can be read here.

"The NHS fully merited its place in Danny Boyle's Olympic opening ceremony". Photograph: Getty Images.

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.

Photo: Getty
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Goodbye, Sam Allardyce: a grim portrait of national service

In being brought down by a newspaper sting, the former England manager joins a hall of infamy. 

It took the best part of 17 years for Glenn Hoddle’s reputation to recover from losing the England job.

Between leaving his job as manager in February 1999 and re-surfacing as a television pundit on ITV during the 2014 World Cup, Hoddle was English football’s great pariah. Thanks to his belief in faith healer Eileen Drewery and a string of unconventional and unacceptable views on reincarnation, he found himself in exile following in a newspaper interview during qualification for England’s Euro 2000 campaign.

But just as Hoddle is now cautiously being welcomed back to the bosom of English football, current incumbent Sam Allardyce has felt the axe fall. After less than two months in charge of the national side and with only a single game under his belt, the former Bolton Wanderers manager was caught up in a sting operation by the Daily Telegraph — allegedly offering guidance on how to circumvent his employer’s rules on third-party player ownership.

The rewards for guiding an English team to major international success promise to be spectacular. As a result, the price for any failure — either moral or performance-related — is extreme.

Hoddle’s successor – the endearing Kevin Keegan – resigned tearfully in a toilet at Wembley after a tumultuous 18-month spell in charge. His replacement, the laconic Sven-Göran Eriksson, provided moments of on-field excitement paired with incredible incidents of personal indiscretion. His tangle with "fake sheikh" Mazher Mahmood in the run up to the 2006 World Cup – an incident with haunting parallels to Allardyce’s current predicament – led to a mutual separation that summer.

Steve McClaren was hapless, if also incredibly unfortunate, and was dispatched from the top job in little over a year. Fabio Capello – who inspired so much optimism throughout his first two years in charge – proved himself incapable of lifting the hex on English major tournament fortunes.

The Italian’s star was falling from the moment he put his name to the oddly timed Capello Index in 2010, although his sustained backing of then captain John Terry over a string of personal misdemeanours would prove to be the misjudgement that ultimately forced his exit. As Allardyce has found out, the FA has become increasingly hard on lapses in moral judgement.

English football is suffused with a strange mix of entitlement and crushing self-doubt. After a decade that has given us a Wimbledon champion, several Ashes triumphs, two Tour de France winners and eye-watering Olympic success, a breakthrough in this area has never felt further away.

In replacing Capello, Roy Hodgson — the man mocked by Allardyce during his hours supping pints with Telegraph reporters — had hoped to put a rubber stamp on a highly respectable coaching career with a spell managing his own country. But this summer’s farcical defeat to Iceland at Euro 2016 put his previous career in a much harsher light.    

Allardyce was a mix of the best and worst of each of his predecessors. He was as gaffe-prone as Steve McClaren, yet as committed to football science and innovation as Hodgson or Capello. He also carried the affability of Keegan and the bulldog spirit of Terry Venables — the last man to make great strides for England at a major tournament.  

And as a result, his fall is the most heartbreaking of the lot. The unfairly decried charlatan of modern football is the same man who built a deeply underrated dynasty at Bolton before keeping Blackburn, West Ham and Sunderland afloat in the most competitive league in Europe.

And it was this hard apprenticeship that convinced the FA to defy the trendy naysayers and appoint him.

“I think we make mistakes when we are down here and our spirit has to come back and learn,” Hoddle mused at the beginning of his ill-fated 1999 interview. As the FA and Allardyce consider their exit strategy from this latest sorry mess, it’s difficult to be sure what either party will have learned.

The FA, desperately short of options could theoretically turn again to a reborn Hoddle. Allardyce, on the other hand, faces his own long exile. 

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